Finding a Pelvic Floor Specialist

Pelvic floor physiotherapists help women rehabilitate their pelvic floor region. The muscle groups within the core and pelvic region can be weakened by childbirth, surgery, genetics, heavy lifting, rapid weight gain, constipation, menopause, improper breathing mechanics, and more. These muscle groups aid in supporting the uterus, bladder, and bowels. They form a slinglike grouping from the pubic bone to the front of the tailbone at the back. Damaged or weakened pelvic floors can affect bladder and bowel control, leading to urinary and rectal incontinence or even pelvic organ prolapse.

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At times, the pelvic floor can become overactive or hypertonic. This means that their pelvic floor muscles are overly tight and tense all of the time, even when they should be relaxed. Learning to relax and release the pelvic floor muscles (muscles contractions like the short contraction of the bulging of a bicep or long contraction, like the slow, contained stretching out of a bicep) will help ease overactivity. An overactive pelvic floor can cause many symptoms such as: back pain, pain during sex, heaviness or incontinence.

Table of Contents

What is a pelvic floor specialist?

Doctors who specialize in pelvic floor dysfunction issues are called urogynecologists and physiotherapists. A urogynecologist will care for women with pelvic floor disorders by providing services that help evaluate pelvic floor health and provide primarily surgical treatments for pelvic organ prolapse. Their speciality covers the muscles, ligaments, connective tissues, and nerves within the uterus, vagina, bladder, and rectum.

A physiotherapist or Occupational therapist who specializes in pelvic floor treatment helps treat pelvic floor issues non-surgically. This is commonly done through exercise and manual therapy as well as extended education and advice on how to properly engage and strengthen your pelvic floor. Other specialists who aid in pelvic floor therapy include movement specialists and occupational therapists. Movement therapy can play a significant part in retraining the body toward correct posture, alignment, deep-tissue manipulation, and provide educational instruction on how the body works and how it heals.

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What is involved in pelvic floor physical therapy?

Pelvic floor therapy most commonly involves exercises and education on how to properly engage and strengthen the pelvic floor. A specialist like a physiotherapist will help instruct their clients with a range of techniques ranging from:

Breathing mechanics
Therapeutic exercise & core building
Pelvic muscle relaxation exercises
Pelvic floor realignment
Post-delivery therapy (vaginal delivery and c-section delivery)
Proper posture
Symptom treatment
Physical education

Pelvic floor therapy seeks to instruct women in how their bodies work while also treating any conditions causing pain or embarrassing symptoms – like pelvic organ prolapse. When seeking treatment for pelvic floor dysfunction or POP, there are a few things you should keep in mind.

Professional Care

When seeking treatment for PFD or POP, make sure that the instructor or doctor is trained and educated in pelvic floor treatment. An initial assessment by a urogynecologist can assist you with a referral to a great physical therapy specialist.

Consultation

Seeking physical therapy for pelvic floor issues does not require a referral from a medical professional. When you see a physio, they will take a full history of your bladder and bowel function, sexual function and medical and surgical history. A pelvic floor assessment is commonly performed through what is called a manual palpation. This is an internal assessment to determine pelvic floor muscle function, strength, and overall health. They will also be interested in your fitness activities.

Treatment

Treatment for PFD could include exercises, biofeedback (electronic monitoring), and manual treatment of the muscles. In my programs I give extensive advice and education regarding daily activities and fitness, as well as good bladder and bowel habits, and proper posture and breathing mechanics. Function based training of the pelvic floor helps get your muscles back to working effectively when you need them.

RYC & Movement Therapy for PFD

In your search for pelvic floor therapy, you should consider a therapist trained in treating those with PFD – someone who is knowledgeable in their field and has experience in treating symptoms of PFD or POP. As an internationally recognized Yoga + Pilates teacher specializing in core and PF issues, I have been working with people for years with various core related issues. I am a longtime movement teacher with 20 years of experience guiding people through injury rehab.

With my years of experience, I have created online exercise programs that are challenging, unique, safe, sustainable, and life-changing for clients experiencing pelvic floor dysfunction or diastasis recti. Many of these clients are dealing with conditions such as pelvic organ prolapse or symptoms like incontinence and chronic pain, as well as core weakness associated with abdominal separation.

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When should you see a pelvic floor professional?

Symptoms vary and differ from person to person. Whether your pelvic floor dysfunction is caused by an underlying illness or disease or caused by incorrect breathing mechanics or a result of an abdominal injury may also increase pain or play a part in the dysfunction of the pelvic region. Some of the most common symptoms associated with pelvic floor dysfunction may include:

Stress urinary incontinence (increase urinary retention or urinary frequency)
Rectal incontinence
Incessant need to pee
Difficulty in emptying your bladder or bowel
A prolapse
Pain in your pelvic region
Pain during sexual intercourse, sexual dysfunction

Tight and overused pelvic floor muscles can result in painful and embarrassing symptoms. Pelvic pain and loss of control with bowel movements can be an embarrassing result of pelvic floor dysfunction. If you are experiencing any of the symptoms above or any other discomfort or pain, you should consider contacting a medical professional to be assessed.

However, if these symptoms are present, there are ways to begin healing and loosen your pelvic floor muscles in order to gain back control over your body.

Pelvic Floor therapy can help

A physiotherapist will help increase muscular mobility and strength while helping reduce pain by teaching gentle stretches and exercises. They are specially trained to help strengthen or rehabilitate the pelvic floor.As you know by now, therapy goes way beyond kegels.

My 12 Week Program: Restore Your Core® offers a step by step approach to strengthening your whole body. If you feel a bit unprepared to tackle a long program, here is a video of 5 exercises that are wonderful to get you started. Regardless of who you see and whether or not a medical professional is needed, PFD physical therapy can assist in treating painful symptoms such as:

incontinence
difficulty with bladder or bowel movements
painful sex
constipation
pelvic pain
endometriosis
vaginismus
menopause symptoms
pregnancy and postpartum wellness

Persistent pelvic floor pain can be difficult to endure.

Pelvic floor dysfunction issues can range between hyperactivity to pelvic organ prolapse. The result of both cases can lead to painful and embarrassing symptoms for both men and women. In this article, I will address helpful exercises and stretches that help free you of painful symptoms and aid in restoring pelvic floor and core function. To be clear, stretching is just one type of input into the pelvic floor system and is not the only thing you should do for a tight / tense pelvic floor. Downtraining your pelvic floor will require a variety of loads and inputs, stretching is one important one.

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FAQ

What is pelvic floor rehabilitation, and who is it for?

Pelvic floor rehabilitation is a process of restoring how the pelvic floor muscles within the larger system of the body, including how they respond to breath, movement, and pressure. Experiences like pregnancy, surgery, menopause, or the accumulation of daily habits can shift how the pelvic floor coordinates and responds, affecting its ability to support continence, the bladder, bowel, and uterus. Many people explore this work when they notice leaking, pelvic pain, a sense of heaviness, or discomfort during sex, and others arrive here out of curiosity about how their body works and how to support it more effectively.

Do I need to see a doctor before starting pelvic floor rehabilitation?

You don’t necessarily need to see a doctor first, but it depends on what you’re experiencing. Some people begin by working with a pelvic health physiotherapist, who can assess how the pelvic floor is functioning through conversation, observation, and hands-on evaluation. In other situations, especially where symptoms feel more complex or unfamiliar, a medical provider can help rule out anything that requires specific medical care. What tends to matter most is having a clear understanding of what your body is doing, so that any movement or rehabilitation work you choose reflects that.

Is pelvic floor rehab just Kegels?

Kegels describe a very specific muscular action, and while that action can have a place in some contexts, pelvic floor function involves much more than repeated contractions. The pelvic floor is constantly responding to breath, posture, load, and movement, and its role shifts throughout the day as you walk, lift, sit, and rest. When the system is approached as a whole, including how the ribs move with breath, how pressure is managed, and how the nervous system participates, the work becomes more about coordination and responsiveness than repetition.

What does an overactive or hypertonic pelvic floor mean?

An overactive or hypertonic pelvic floor is one that holds too much tension, limiting its ability to lengthen and respond. This ongoing state of contraction can show up as pelvic pain, discomfort with penetration, back or hip tension, or even leaking, since muscles that cannot fully release also have difficulty generating an effective contraction. With an overactive or hypertonic pelvic floor, the work often involves helping the muscles move between contraction and release again, rather than staying fixed in one state.

Can I work on my pelvic floor at home, or do I need in-person therapy?

Yes, a home program can be a great place to start, especially when it guides you through how your body moves, breathes, and manages pressure across different positions and activities. In-person care adds another layer through hands-on assessment and individualized feedback, and for many people, the two approaches complement each other. Programs like Restore Your Core® are designed to translate these principles into a structured, progressive format that you can explore at home and adapt to where your body is right now.

What causes pelvic floor dysfunction in women?

Pelvic floor dysfunction tends to develop through a combination of factors that accumulate, including experiences like pregnancy and birth, surgery, hormonal shifts, repetitive strain, chronic constipation or long-standing breathing or postural habits. Over time, they change how the body as a whole manages pressure and movement, not just the pelvic floor. This is why approaches like Restore Your Core® are structured around the whole body, where breath, core coordination, nervous system state, and movement patterns are explored together rather than separating the pelvic floor from the rest of the system.

What's the difference between a weak pelvic floor and a tight one?

A pelvic floor that has difficulty generating force can show up as leaking or a sense of reduced support, while a pelvic floor that holds too much tension can limit its ability to lengthen and respond, often showing up as discomfort, pain, or restriction. These patterns can overlap, as muscles that remain contracted for long periods of time can lose their ability to contract, relax, and respond appropriately. When pelvic floor function is explored within the context of breath, movement, load, and pressure management, it becomes clearer what’s happening and what kind of support the body and pelvic floor need.

Can pelvic floor problems get better without surgery?

Yes, many people see meaningful improvement without surgery through approaches that work with the body’s ability to adapt and reorganize, including movement-based rehabilitation, breathwork, and physiotherapy. These approaches support the body’s ability to manages load and pressure in everyday movement and activity, which can influence symptoms. Restore Your Core® is a structured, at-home program that guides you through progressive movement to improve coordination and awareness so the body has the input it needs to change. Surgical care can be part of some people’s path, but surgery alone doesn’t address the underlying movement and pressure management patterns that contribute to the problem. Rehabilitation both before and after any procedure helps to ensure the best possible outcome.

How long does it take to see improvement with pelvic floor rehabilitation?

The pace of change reflects a number of factors, including how long current patterns have been present, how consistently someone is with their rehab exercises, and how the body responds. Some people begin to notice changes in their symptoms within a few weeks, while for others the process unfolds more gradually as coordination improves and strength increases. Restore Your Core® is designed to guide this process through a structured progression that builds over time, so changes carry into everyday movement and activity.

Is pelvic floor dysfunction something I just have to live with after having children?

No. Changes in the pelvic floor are common after pregnancy and birth, as the body adapts to significant shifts in load, pressure, and tissue demand. These changes can include leaking, heaviness, or discomfort, and they often reflect how the system is currently organizing itself rather than a fixed state. With the right kind of support, many people experience their body continuing to adapt as they build awareness of how they move, breathe, and respond to load throughout daily life. Restore Your Core® 12-Week Program is designed to guide that process in a way that feels structured and accessible from home.

How is stress incontinence different from urgency incontinence?

Stress incontinence is leaking triggered by physical pressure on the bladder – sneezing, coughing, laughing, lifting, jumping. Urgency incontinence involves a sudden strong urge to urinate that can be difficult to defer, sometimes leading to a leak before reaching the bathroom. Some women experience both, which is called mixed incontinence. The distinction matters because the mechanisms differ and the primary approaches differ as well. Stress incontinence tends to respond to pelvic floor coordination and pressure management work; urgency incontinence often also involves bladder retraining and nervous system regulation. A pelvic floor physiotherapist can assess which pattern is present and guide accordingly.